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目的:探讨贲门癌手术式选择对术后食管反流情况、临床症状及生存期的影响。方法:选取研究对象269例,其中T(total gastrectomy)组106例采用全胃切除术,P(proximal gastrectomy)组163例采近端胃切除术用,术后半年至一年复诊胃镜观察食管下端、贲门区有无胆汁黄染及食道下段有无粘膜糜烂。总结5年生存率,并对术后并发症的发生率和病死率进行对照分析。结果:胃镜病理检查结果显示:实验组食管胃吻合口的炎症反应比对照组轻(P<0.05),本组患者术后总的5年生存率为40.12%,其中T组为44.7%;P组为37.2%,经统计学处理,两组5生存率差异具有显著性意义(P<0.05)。结论:相对近端胃切除术全胃切除术的术后生存质量明显有优势,5年生存率也较高。
Objective: To investigate the effect of surgical selection of cardia cancer on postoperative esophageal reflux, clinical symptoms and survival. Methods: Totally 269 subjects were selected. Totally 106 patients underwent total gastrectomy (TGA) with proximal gastrectomy (163 cases) underwent proximal gastrectomy. The distal end of the esophagus was examined by endoscopy six months to one year after operation , Cardiac area with or without bile yellow dye and mucosal erosion of the lower esophagus. The 5-year survival rate was summarized, and the incidence of postoperative complications and mortality were compared. Results: The results of gastroscopic examination showed that the inflammatory reaction of esophagogastric anastomotic in the experimental group was lighter than that in the control group (P <0.05). The overall 5-year survival rate was 40.12% in the experimental group, 44.7% in the T group; P Group was 37.2%, statistically significant difference between the two groups of 5 survival rate was significant (P <0.05). Conclusion: The total quality of life after total gastrectomy of proximal gastrectomy has obvious advantages and the 5-year survival rate is also higher.